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Abstract：
Gestational trophoblastic neoplasia (GTN) is an uncommon group of pregnancy-related malignancies. Delayed diagnosis is a prognostic factor for worse outcome. GTN is even harder to diagnose if the site of metastasis is uncommon. The reported case is a 27-year-old G2P1A1 woman who presented to our center with acute transient generalized tonic-clonic seizure. She had developed hemoptysis for the 2 preceding weeks, which had been treated as pneumonia. She had then noticed multiple gum lesions and vaginal spotting 1 week before her presentation. Her serum β-human chorionic gonadotropin level was 77,474 IU/L without evidence of pregnancy. She was diagnosed with GTN with lung, brain, and gum metastases. The patient was staged as IV with a World Health Organization prognostic score of 14. Etoposide, methotrexate, actinomycin D alternating with cyclophosphamide, and vincristine weekly (EMACO) were given. The gum lesions disappeared after 2 cycles of the multiagent chemotherapy, and complete remission was achieved after 8 cycles. This case study will increase awareness of uncommon metastatic sites of GTN. Any associated vaginal bleeding should be considered a clue to metastatic GTN.
摘要：
妊娠滋养细胞肿瘤（GTN）是一组罕见的妊娠相关恶性肿瘤。延迟诊断是预后较差的预后因素。如果转移部位不常见，则GTN更难诊断。报告的病例是一名27岁的G2P1A1妇女，她因急性短暂性全身性强直阵挛性癫痫发作来到我们中心。前两周她出现咯血,曾被视为肺炎。然后，她在就诊前1周注意到多处牙龈病变和阴道斑点。她的血清β-人绒毛膜促性腺激素水平为77,474IU/L，无妊娠迹象。她被诊断为GTN合并肺,大脑,和牙龈转移。患者分期为IV，世界卫生组织预后评分为14。依托泊苷,甲氨蝶呤,放线菌素D与环磷酰胺交替，每周给予长春新碱（EMACO）。经过2个周期的多药化疗后，牙龈病变消失，8个周期后完全缓解。此案例研究将提高对GTN罕见转移部位的认识。任何相关的阴道出血应被认为是转移性GTN的线索。
